Rabies

• DHS Rabies fact sheet, P-42081
• Wisconsin Rabies Prevention flowchart (Rabies algorithm)

Animal bite management and potential rabies exposures in humans

One of the most effective ways to prevent rabies infection is immediate, thorough cleansing of the animal bite or scratch wounds with liberal amounts of soap and water for 10-15 minutes.

It is important for bite victims to notify their local health department (or local law enforcement when public health staff are unavailable) whenever a bite occurs to ensure that the biting animal is appropriately and legally observed or tested for rabies. It is also vital not to release or destroy a biting animal until a public health official or an animal control officer is consulted. The victim's physician should also be notified promptly.

In most instances, observation or testing of the biting animal will rule out the possibility of rabies and will therefore eliminate any need for the bite victim to undergo the series of injections. If circumstances of the exposure warrant it, however, a physician will administer preventive medications (called post-exposure prophylaxis) to the bite victim. This preventive treatment consists of an injection of rabies immune globulin immediately, and four doses of the rabies vaccine given over the course of 14 days. The vaccine is injected in the arm, similar to a tetanus shot. Visit the preventive post-exposure regimen web page for details.

Exposures to bats are worrisome because some people with very minor exposures to bats have contracted rabies. If there has been any possibility of physical contact with a bat, even without a known bite, the animal should be safely captured and held until a public health official or a physician can be consulted.

It should be noted that domestic animals that are exposed to rabies constitute a very real threat to their human owners, particularly if the animal is unvaccinated.

Prevention Measures
Exposure to rabies may be minimized by the following measures:

• Eliminate stray dogs and cats and enforce leash laws.
• Vaccinate pet dogs, cats, ferrets, and livestock against rabies.
• Stay away from all wild animals, especially those acting abnormally.
• Teach your children not to approach any unfamiliar animals.
• Do not keep exotic or wild animals as pets, regardless of how young or cute they are.
• Exclude bats from living quarters by keeping screens in good repair and by closing any small openings that could allow them to enter.
• Persons traveling to developing countries in which rabies is highly prevalent, or persons who are at ongoing risk of possible rabies exposure (e.g., veterinarians, animal control officers), should ask their doctor about receiving the PRE-exposure rabies vaccinations.

Consultation resources

• Members of the public should contact their local public health department (county or municipal) and their health care provider regarding animal bite/rabies concerns. During off-hours, animal bite calls may be handled by local law enforcement personnel.
• The Communicable Disease Epidemiology Section of the Division of Public Health (DPH) offers consultation on situations involving potential human exposures to rabies.
  • Local health department staff or health care providers can call 608-267-9003 during regular office hours, or the DPH emergency answering service at 608-258-0099 on nights and weekends, in order to consult with an epidemiologist.
• Questions regarding the submission of specimens for rabies testing to the State Laboratory of Hygiene, or about the reporting of test results, can be addressed to the SLH Customer Service at 800-862-1013 during regular office hours.
• To consult about potential animal exposures to rabies, callers can contact Dr. Yvonne Bellay at the Wisconsin Department of Agriculture, Trade and Consumer Protection (DATCP) at 608-224-4888. It should be noted that domestic animals that are exposed to rabies constitute a very real threat to their human owners. Information about rabies quarantine requirements for animals are available on DATCP’s website.
• Child/Bat Encounters on school grounds video resources for school administrators and staff (English and Spanish)
• CDC - rabies
• Rabies epidemiology in Wisconsin
• Rabies, an Overview – A review of epidemiology, clinical aspects and the prevention and control of rabies in Wisconsin
• Rabies 201 - Focus on the Lab

Animal bite management from the perspective of rabies prevention:
Wisconsin Rabies Prevention flowchart (Rabies algorithm)

Rabies is a Wisconsin disease surveillance category I disease:
Report IMMEDIATELY by TELEPHONE to the patient's local public health department upon identification of a confirmed or suspected case. The local health department shall then notify the state epidemiologist immediately of any confirmed or suspected cases. Submit a case report within 24 hours submit a case report electronically through the Wisconsin Electronic Surveillance System (WEDSS), by mail or fax using an Acute and Communicable Disease case report, F44151 (Word) or by other means Information on communicable disease reporting

• Case Reporting and Investigation Protocol (EpiNet): P-01901 Rabies (PDF)
• Wisconsin Rabies prevention flowchart (Rabies algorithm)

Human Rabies Prevention CDC MMWR publications

• CDC MMWR Human rabies prevention 2008 with an important revision at
  CDC MMWR Use of a Reduced (4-Dose) Vaccine schedule for postexposure prophylaxis to prevent rabies 2010
• Diagnostic Testing
• Wisconsin State Lab of Hygiene
• Wisconsin Statutes – Rabies control
• Rabies information for physicians
• Pediatric Grand Rounds Presentation on Rabies Prevention University of Wisconsin School of Medicine and Public Health, 02/15/2018 by Dr. Jim Kazmierczak
• Rabies, an Overview – Rabies and Animal Bite Management (runtime 55:52:00)
• Rabies 201 – Focus on the Laboratory (runtime 24:42:00)